Health Care Licensing Boards Should Refer for Criminal Prosecution Any Mental Health Practitioner Found to Have Engaged in Sex with a Patient

It is hard to understand how a state agency can permit a mental health practitioner (psychiatrist, psychologist, psychotherapist, clinical social worker, professional counselor) to continue to treat the public despite having been found to have engaged a patient in sexual relations. Mental health patients are not the same as patients receiving medical treatment. Individuals seeking mental health treatment are usually already in a fragile mental/emotional state and so come to the therapist depressed, confused and/or insecure. Some are victims of violence or sexual abuse or have suffered other losses that have reduced their ability to enjoy life. Mental health patients are widely recognized by experts and the law as being extremely vulnerable.

A patient visiting a general practitioner or any other type of specialist is not there due to such emotional distress and vulnerability.

For this reason, it is particularly heinous for a mental health practitioner to manipulate vulnerable patients for sexual gratification. The exploitation of the patient’s vulnerability constitutes a betrayal of considerable magnitude—far greater than if a general practitioner or other specialist did the same thing.

While offending mental health practitioners have offered up some astounding justifications for having sex with their patients, few, if any, have ever claimed ignorance of the rules, regulations or codes prohibiting it. The Hippocratic Oath forbids. The American Psychiatric Association however merely calls it “unethical” (and few are the psychiatrists banned from that Association for sexual acts with patients).

Anyone doubting the issue should visit the Citizens Commission on Human Rights’ database of convicted mental health practitioners at www.psychcrime.org. Enter the search terms “sex” or “rape,” to see several hundred such patient sex-related cases.

With routine sexual abuse or sexual assault of patients by mental health practitioners being met by toothless professional codes and too-often-lenient administrative discipline, it is no surprise 19 states enacted laws making it a crime for a mental heath practitioner to engage in sex with a client. A smaller handful of states have regulations that allow or require licensing boards to refer detected sexual exploitation of a patient for criminal prosecution. The following data is being presented to all state health care licensing boards in the hope that they will recognize the need and the value to the public of making such referrals.

The following are some recent examples on which this should have been done:

  • Kansas psychologist James D. Wright expressed attraction to a patient, with whom he subsequently engaged in hugging, kissing and oral sex. He was subsequently “disciplined” with a stayed two-year suspension of his license.1

  • Nevada psychiatrist Robert L. Horne engaged in a relationship with a former patient. He was reprimanded and fined.2

  • Michigan psychologist John G. Roe had his license suspended by the state Department of Community Health for at least six months and one day for conducting a relationship with a patient for several years.3

  • Connecticut psychologist Reuben Spitz engaged in a sexual relationship with the wife of a patient within two years of the termination of the therapist-patient relationship. He was placed on two years’ probation (during which he can continue to practice).4

  • Washington mental health counselor Natalie N. McKinley became “romantically involved” with a client and married him a month later. The Department of Health suspended her credential for three years.5

  • Ohio mental health counselor Melvin D. Johnson was suspended for one year for failing to comply with the terms of an earlier order suspending his license for two years for engaging in “an inappropriate relationship of a sexual nature with a female client.”6

  • Vermont licensed clinical social worker Natalie Ann Trombly engaged in a sexual relationship with a client that lasted several weeks. She was ordered by the state licensing authority to complete a graduate level ethics course, undergo an evaluation and have her practice supervised for an unspecified length of time.7

These cases are only a few examples of mental health practitioners that will continue to practice, despite having violated the ethical codes of their professions as well as state laws and/or rules and/or regulations.

They have also violated a long-held moral standard which has even been recognized by our courts: In the landmark 1976 case of Roy v. Hartogs, one of the first in which a woman successfully brought suit against her therapist on these grounds, the court held: “Thus from [Freud] to the modern practitioner we have common agreement of the harmful effects of sexual intimacies between patient and therapist.”8

In his 2001 report, "Sex Between Therapists and Clients,” Kenneth Pope, the former head of the Ethics Committee of the American Psychological Association wrote: “The health care professions at their earliest beginnings recognized the harm that could result from sexual involvement with patients. The Hippocratic Oath, named after a physician who practiced around the fifth century B.C. prohibits sex with patients…. The historical consensus among health care professionals that sex with patients is prohibited as destructive has continued into the modern age.9

The ultimate toll of that harm is patient suicide. About 14% of those who have been sexually involved with a therapist will make at least one attempt at suicide. One in every hundred patients succeeds.10 Factoring in the fearful silence of most victims—only an estimated 1% actually report the abuse—tens of thousands of patients of psychiatric therapists have committed suicide, and thousands more have been hospitalized because of the harm caused to them.

If a patient ever complains, offending psychiatrists first blame the patient's "mental illness," then the patient's inability to "come to terms" with their earlier traumatic experience. Finally, psychiatrists frequently argue that the patient consented to the "relationship," despite the obvious abuse. Some have even been known to take drastic and illegal steps to prevent the sexually abused patient from exposing them: California psychiatrist Thomas Brod treated a female patient with whom he attempted to initiate a romantic relationship, hugging and kissing her during therapy sessions. He later convinced her to have sex with him because “it would be good for her therapy.” Several years later when the patient wanted to end their relationship, Brod had her committed to a psychiatric facility. The California Medical Board placed him on two years probation.11

Nineteen states have psychotherapist sexual exploitation laws making sexual contact with a patient by a psychotherapist a crime, with penalties of up to 10 years imprisonment and $20,000 in fines.

The fact is, these kinds of complaints are being filed and investigated continually. Administrative discipline, as meted out by our state licensing boards, is often insufficient, as evidenced by the above cases and many more like them.

Not all state licensing boards take the time to refer such cases to law enforcement for investigation and prosecution, though every such case ought to be, especially in states that have a psychotherapist sexual exploitation law. In Florida, such referral is mandated by law. In states that do not yet have such laws, the cases should still be referred on the basis of felony rape or sexual assault or battery.

The Citizens Commission on Human Rights calls upon our state health care licensing boards to begin making these referrals mandatory when a sex crime is detected.

For more information, please contact Steve Wagner, Director of Litigation at swagner@cchr.org.

1 Disciplinary entry on James D. Wright, Ph.D., as published on the website of the Kansas Behavioral Sciences Regulatory Board, 31 July 2007.

2 Disciplinary entry on Robert L. Horne, as published on the website of the Nevada Medical Board, 20 April 2005 and 28 March 2008.

3 “Slain woman's psychologist's license suspended,” Grand Rapids Press, 12 July 2008.

4 Memorandum of Decision, Reuben T. Spitz, Ph.D., Petition No. 2006-1201-008-009, Connecticut Board of Examiners of Psychologists, 6 June 2008.

5 Stipulated Findings of Fact, Conclusions of Law and Agreed Order, In the Matter of Natalie N. McKinley aka Natalie N. Gomez, Docket No. 07-11-B-1009RC, No. M2008-109031, 20 June 2008.

6 Adjudication Order in the Matter of Melvin D. Johnson, Ohio Counselor, Social Worker and Marriage and Family Therapist Board, 21 March 2008.

7 Stipulation and Consent Order, In Re: Natalie Ann Trombly, Docket No: 03-0407, State of Vermont Secretary of State Office of Professional Regulation, 24 April 2008.

8 Kenneth Pope,“Sex Between Therapists and Clients,” Encyclopedia of Women and Gender: Sex Similarities and Differences and the Impact of Society on Gender, (Academic Press, Oct. 2001).

9 Ibid.

10 Ibid.

11 Stipulated Settlement and Disciplinary Order in the Matter of the Accusation Against Thomas M. Brod, M.D., No. D-5408, OAH No. L-61681, 22 November 1994.


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